Journal of Shahrekord University of Medical Sciences
Year:2006 | Volume:8 | Issue:1|Papers Count:14

Background and aim: Polycystic ovaries syndrome (PCOS) is the most common endocrine disorder in infertile women with unovulatory cycle. This disorder is associated with abnormal circulating hormones but its effect on early embryonic development and pregnancy rate is unknown. The aim of this study was to compare the fertilization rate, embryo quality and pregnancy rate between 130 patients with polycystic ovary syndrome and 130 women with tubal factor for infertility and normal ovaries.Methods: One-hundred and thirty women with PCOS and 130 women with tubal infertility underwent Invitro fertilization (IVF) and Intracytoplasmic sperm injection (ICSI) treatments in Isfahan infertility center. Number of oocyte and embryo, fertility rate and embryo quality was compared between the two groups.Results: Our results showed that average of oocyte retrieved, produced embryos and cumulative embryo quality score were higher in PCOS patients than in the tubal factor group. However, the fertilization rate was not different between the two groups (p<0.05). The clinical pregnancy rate in PCOS patients was higher than the tubal factor group (p<0.05).Conclusion: The probability of pregnancy in patients with PCOS is higher than patients with tubal factor. This is mainly due to selection of an embryo with high potential of earning and development.

Background and aim: Renal colic pain is a problem in emergency rooms and for some out- patients. Narcotic drugs are the drugs of choice for pain relief in these patients, but possible abuse, inaccessibility and some complications limit their usage. Recently desmopressin drop has been proposed as an analgesic. This drug is used by nasal route and has physiologic effects for pain relief in renal colic. In this study, we compare the analgesic effects of this drug with pethedin, one of the drugs of choice in renal colic.Methods: Sixty-eight renal colic patients (43 men, 25 women) were randomly divided into two equal groups. The first group was treated with 25 mg intramuscular pethedin and the second group treated with 40 μg intranasal desmopressin. Pain intensity was measured at admission, 10 and 30 minutes after the drug administration with McGill pain questionnaire.Results: Pethedin resulted in a decrease of pain from 12.7±0.6 to 10.1±0.5 at 10 minutes and to 2.9±0.5 at 30 minutes after the drug administration. Desmopressin caused a decrease of pain from 11.5±2.8 to 10.1±0.6 at 10 minutes and 9.5±0.5 at 30 minutes after the drug administration. The difference was significant (p<0.01).Conclusion: The results of this study revealed that desmopressin is not effective for pain relief and pethedin is a drug of choice for renal colic.

Background and aim: The basic development needs (BDN) are effective on human health. Since there was no research about the effects of BDN on the health indicators, this study was carried out to compare health indicators in pilot villages of BDN in Charmahal and Bakhtiari province.Methods: A 4 years period (2000-2004) case-control study was carried out in 8 villages (4 cases and 4 controls) of Saman city. First, a questionnaire about access to healthy bath, collection system for garbage, collection system of waste water, access to sanitary toilet, income and social projects was filled for 1582 families in each group of case and control. Then BDN project was carried out in the case villages for a period of four years. Then the above questionnaire was filled again for all the villages. The results were statically analyzed using chi-square test.Results: All the health indicators were improved in the case group (p<0.001).Conclusion: BDN improves the health indicators, family income and participation in the social projects.

Background and aim: Nutrition is an important factor in patients with chronic kidney disease. An inadequate nutritional regimen decreases the life quality and leads to high mortality and morbidilty in these patients. Therefore, this study was performed to determine the effect of dietary regimen education on the laboratory variables and interdialytic weight gain in hemodialytic patients.Methods: This quasi-experimental study was carried out on a group of 32 hemodialytic patients (pretest-posttest) in the educational hospitals of Iran and Tehran medical science universities in 2003-2004. The patients were assessed by a questionnaire about their educational needs before starting dialysis. The laboratory variables were analyzed by two-month average before the education and interdialytic weight gain was measured at four stages with a time interval of two weeks. Then, an educational program on the basis of Orem theory, existing problems, characteristics of the patients and the required education was presented in four sessions, (each sessions lasted 20 minutes). At the end of the educational period, the laboratory variables (average two months) and interdialytic weight gain were studied at four stages with a time interval of two weeks (third and fifth weeks). Data was analyzed, using t test.Results: The findings showed that there were significant decreases in serum levels of urea (p<0.001), uric acid (p<0.01), phosphorous (p<0.01) and K (p<0.005). Interdialytic weight gain, between two sessions of hemodialysis, was also decreased (p<0.001). However, there were no statistically significant differences in serum levels of Na, Ca, Cr and albumin.Conclusion: Performing of the educational program for nutrition may have positive influence on decreasing the problems of hemodialytic patients.

Background and aim: Adenotonsillectomy is a common operation in children, which may have numerous complications after ansethesia. Postoperative pain is a serious complication that causes irratability, rebleeding and other problems. Since the anesthesia method may affect the postoperative complications, the aim of this study was to compare the effects of atracurium and succinylcholine on post adenotonsillectomy pain in children.Methods: This clinical trial study was performed on eighty children of 3-12 years old who were candidate for adenotonsillectoy surgery. These children were subjected to two methods of general anesthesia. For muscle relaxation, atracurium was given to one group and succinylcholine to the other group. Using Ocher's test the severity of post operative pain was measured.Results: Means of post operative pain (p<0.05) and heart rate (p<0.01) in succynil group were more than those of atracurium group. However, rebleeding, hemmorage and vomiting after anesthesia were not significantly different between the two groups.Conclusion: Our results showed that the patients who were given atracurium had deeper anesthesia, less pain and were more comfortable than the other group.

Background and aims: High prevalence of depressive disorder and its disabling effects probably result in adverse effect on normal growth of fetus and on birth growth indices of newborns. Most importantly, their postnatal quality of life may be affected by these indices.This study was performed to compare birth growth indices between newborns of depressed and non-depressed women.Methods: This descriptive-analytical, prospective and cohort study was carried out on 320 pregnant women from Najafabad city during the third trimester using simple randomization. By using standard Beck depressive scale test, the women were assessed for depression. Subsequently, the information about the birth growth indices of their newborns were obtained from their family files after delivery. By using, t and χ2   tests, the data was analyzed.Results: The prevalence of depression in pregnant women was 29.3% and it had a significant relationship with unwanted pregnancy (p<0.01) but it wasn't related to age, previous abortion, physical illness and demographic characteristics. The means of weight, height and head circumference at birth in newborns from depressed women were significantly lower than those of non-depressed women (p<0.001).Conclusion: The means of growth indices in newborns from depressed women were significantly lower than those of non-depressed women. Thus, the depressed mothers should be considered more than the others by health and medical system.

Background and aim: Malnutrition has great effects on causing various diseases such as cardiovascular diseases, stroke, cancer, diabetes, digestive disorders as well as bone and joint diseases. As the childhood experiences are the main causes of bad hygienic behaviors, this study was performed to determine the effect of health education on nutritional behaviors modification among primary school students of Qazvin.Methods: This quasi-experimental study was carried out on 176 students, in two groups of case and control. A questionnaire of three parts, (demography, knowledge and behavior) and a checklist of direct observation were used to collect data. Two educational methods were used: direct education (face to face education with question) and indirect education (using booklets and other educational subjects). At the end of the education, the effects of educational programs on knowledge and behaviors of the students were assessed.Results: The results showed that there were significant increases in knowledge (from 23.61±6.21 to 30.62±4.96) and nutritional behaviors (from 19.98± 6.63 to 13.19±7.08) after education (p<0.01). Also education had a positive effect on changing the breakfast habit p<0.05.Conclusion: Based on the results of this study and due to importance of the role of students in the future and low expense of health education, extension of similar education programs is necessary.

Background and aim: The early diagnosis of abnormal progress of labour and prevention of long term delivery are the main keys to reduce fetal mortality rate due to hypoxia and tissue ischemia. One of the WHO’s proposed methods for prevention of abnormal delivery is using partogram. Therefore, this survey was conducted to evaluate WHO's partogram alert line for APGAR score at the first minute after birth.Methods: This descriptive–analytical study was performed on 140 pregnant women under partogram in Shahrood Fatemieh hospital. Using the partogram alert line, the progress of labour, mother's and infant's condition started to be controled from 3 cm dilation of the cervix. Decision for resuscitation was made based on respiration, heart rate and skin color of the infant 20 to 30 seconds after the birth. Tools of this research were a questionnaire, inspection form consisted of WHO's partogram and step by step resuscitation form. χ2, t–test and analytical methods of sensitivity, specificity and negative and positive values were used for data analysis.Results: The results showed that 68.8% of the subject's cervical dilatation remained on or to the left side of the alert line and 28.6% was on the right side and 2.9% was on or to the right side of the active line.According to χ2 test, there was a significant relationship between the first minute APGAR score after delivery and the location of cervical dilation. The value of alert line for surveying of APGAR score at the first minute after birth had a sensitivity of 25%, specificity of 96.87%, negative and positive predictive value of 75.6% and 76.92%, respectively.Conclusion: Our results showed that using WHO's partogram prevents long term delivery, helps for on time diagnosis of fetal distress and reduction in stillbirth and fetal mortality. So, partogram should be a part and parcel of fetal and maternal health care.

Background and aims: Drug injection is a very important risk factor for viral hepatitis and human immunodeficiency virus (HIV) infection. The present study was performed to evaluate the prevalence of hepatitis (B and C) and HIV infection among intravenous drug users (IDUs) and to identify the related risk factors for these infections in this group.Methods: This descriptive-analytical study was conducted in 2004 in Shahrekord, Iran. The study population consisted of 133 IDUs in a voluntary drug treatment center. Demographic information and HBV, HCV, HIV-related risk behaviors were obtained through an interviewer–assisted questionnaire. IDUs serum samples were screened for HBV, HCV and HIV infection using enzyme-linked immunosorbent assay (ELISA). All HIV positive samples were confirmed by western blotting. Results: Of the 133 IDUs, 1(0.75%) was HIV+, 15 (11.2%) were HCV+ and 8 (6.2%) were HbsAg+. The prevalence of HCV and HBV infected IDUs was 33.4 and 31.13, respectively. The prevalence of HCV infection was more than the prevalence of both HBV and HIV infection. Using Chi-Square test it was found that there was a significant correlation between using shared syringe and infection with HIV, HCV and HBV (p<0.05).Conclusion: Based on the results of this study, IDUs have elevated prevalence of HCV, HBV and HIV infection in Shahrekord and the main risk factor associated with these infections is drug injection.

Background and aim: Muscle cramp is a painful unusual local contraction of a muscle or part of a muscle. Between 5 to 30% of women complain from leg cramps during their pregnancy. Magnesium plays an important role in muscular function and metabolism. There is no adequate combination of Magnesium in Iran. As Magnesium interacts with both vitamin B1 and B6s and consuming these vitamins during pregnancy has no risk to the pregnant women, this study was performed to find the therapeutic effects of a combination of theses two vitamins on leg cramps during pregnancy.Methods: In this prospective double blind clinical study, 63 pregnant women who had leg cramps during their pregnancy were studied for frequency, intensity and time of the cramps. They were given coincidentally 56 capsules contained 250 mg of vitamin B1 and 240 mg of vitamin B6 or 56 capsules containing starch. They were advised to take two capsules daily for four weeks. Subsequently, the patients were assessed for frequency, intensity and time of cramps.Results: Our results showed that following treatment, the frequency and intensity of the cramps were significantly lower in the case group than those of the control group (p<0.001, p<0.01). However, there was no significant difference in time of cramps between the two groups. No side effect was seen following the use of two vitamins or placebo.Conclusion: It seems that the prescription of vitamin B1 and B6 is more effective than placebo in decreasing frequency and intensity of leg cramps during pregnancy.

Background and aim: Compartment syndrome following the injuries in earthquake is a big problem and may cause amputation and psychological problems. The aim of this study was evaluation of the effects of fasciotomy on the prognoses of these patients, especially for the function of the limbs and the function of the kidneys.Methods: In a clinical trial all patients referred to Alzahra hospital in Isfahan city from the Bam earthquake area, were taken part in this study. The compartment pressure was measured and following suitable liquid therapy, they were fasciotomized. Then, the bloodshed, infections, fever and the prognoses of the operation especially the need for amputation were recorded. The kidney function was also evaluated by measuring the creatinine. Results: Twenty patients out of 255 patients referred to Alzahra hospital, from the Bam earthquake had compartment syndrome in 26 limbs. These patients were fasciotomized. The average of their age was 36.1 years and 55% of them were female. 1.1 cases had pulses in their limbs. However, all of them had hardness and inflammations in their limbs, without any function. Before surgery, 5 patients had increased blood creatinine. 2 months after surgery, all patients had normal kedney function. 3 patients had amputation.Conclusion: Fasciotomy in patients with compartment syndrome may rescue patients limbs, without any significant adverse effects on their kidney function, and is recommended for all patients with this particular problem.

Background and aim: Adenotonsillectomy is a common surgical operation which is frequently associated with complications such as pain, hemorrhage and laryngospasm. For reduction of the possibility of postoperative bleeding and agitation, pain control is important. The opioid drugs are now being used for pain control, but their inconvenient side effects such as apnea may worry physicians. Therefore, the aim of this study was to compare the effect of local application of bupivacaine and dexamethasone with that of placebo on postoperative pain of adenotonsillectomy.Methods: This double-blind and case-control study was performed on 90 patients subjected to tonsillectomy operation with 3-30 years old, during spring and summer of 2005 in Kashani hospital, Shahrekord, Iran. The patients were randomly divided into three equal groups of A, B and C. The individuals in group A (cases) received a local injection of 2 ml of 0.5% bupivacaine, group B received a local injection of and group C (control) received a local injection of 2 ml of normal saline. Six, 12 and 18 hours after the operation, using McGill questioners, pain intensity was evaluated. Data was analyzed using c2 test.Results: Mean age was not significantly different among the 3 groups. 45.6% of the patients were male and the rest were female. Six hours after the operation, pain intensity in group received bupivacaine was more than that of in group received placebo (p<0.05). However, 12 and 18 hours after the operation there was no statistically significant difference in pain intensity among the groups.Conclusion: bupivacaine and dexamethason with dosage used in this study had no effect on pain intensity in these patients.